Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit



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Day II / Postconference

Agenda: Preconference Symposia
Thursday, November 13, 2014

7:00 am Registration (Registration Optional; Choose one)

PRE-CONFERENCE I: PREDICTIVE MODELING BASICS AND BEYOND
8:30 am

Predictive Modeling Basics and Beyond: an in-depth workshop covering Health Care Predictive Analytics fundamental concepts, as well as how these concepts relate to some more advanced applications.

Ian Duncan, FSA, FIA, FCIA, MAAA
Adjunct Professor of Actuarial Statistics, Department of Statistics and Applied Probability, University of California, Santa Barbara, Santa Barbara, CA

    Speaker Bio

    Mr. Duncan is Adjunct Professor of Actuarial Statistics, Department of Statistics and Applied Probability, University of California, Santa Barbara, Santa Barbara, CA. Ian recently served as Vice President, Outcomes and Analytics for the Walgreen Cos. in Deerfield, IL. where he was responsible for all the company's clinical research and publications. He was formerly president and founder of Solucia Consulting, a SCIOinspire company, a provider of analytical and consulting services to the healthcare financing industry.

    Mr. Duncan holds a post-graduate degree in economics from Balliol College, Oxford, and is a fellow of the Society of Actuaries, the Institute of Actuaries (London) and the Canadian Institute of Actuaries. He is active in public policy and healthcare reform, and serves on the boards of directors of the Commonwealth of Massachusetts Healthcare Connector Authority and SynCare, LLC. Academically, he is a Senior Scholar of the Dept. of Health Policy of the Thomas Jefferson Medical College, an Adjunct Research Professor of the School of Healthcare Administration at Georgetown University, and Visiting Professor of Actuarial Mathematics in the Dept. of Probability and Applied Statistics at the University of California, Santa Barbara. He is the author of a number of peer-reviewed papers, (two of which have won best-paper awards from the Disease Management Association of America) and a number of books. His books include "Managing and Evaluating Healthcare Intervention Programs" (Actex Publishers, 2008) and "Healthcare Predictive Modeling and Risk Adjustment" (April 2011).
    Presentation Material (Acrobat)
12:00 pm Pre-Conference Adjournment and Networking Luncheon for Preconference Attendees

PRE-CONFERENCE II: PREDICTIVE MODELING INNOVATIONS
8:30 am

Predictive Modeling Innovations: featuring case study presentations from selected organizations discussing specific predictive analytic solutions applied to various health care settings of interest.

Clive Riddle
President, MCOL; Publisher, Predictive Modeling News, Modesto, CA (Moderator)

    Speaker Bio

    Mr. Riddle is President of MCOL, a leading publisher of health care business information founded in 1995. He has overseen the company's growth from its original on-line membership service to now also include a number of divisions encompassing print and electronic publications, directories and databases, webinar services, B2B social media sites, announcement services, website content, the new rNimble healthcare microconsulting service and more.

    A 30+ year veteran of the health care and managed care industry, Riddle has held a variety of high-level leadership positions including 12 years as Chief Executive Officer of a regional hospital owned managed care organization in California. There he was responsible for developing and overseeing HMO, PPO, insurance, clinic and pharmacy operations, where they developed into a $100 million-a-year business. Prior to that, Mr. Riddle held positions of increasing responsibility for the same hospital system, at both the facility and regional level, where he was charged with the implementation of numerous new programs, facilities and services.

    Riddle's first novel: Dorris Bridge, was released in December 2010 and his second novel The Burning Z was released in 2013. Throughout his career, Mr. Riddle has been an active participant on numerous community and professional boards of directors. He is a native of California, and earned his Bachelor of Arts degree in Business Administration, and Master of Public Administration degree at California State University, Stanislaus.


Aligning Patient Demand and Supply of Health Services

Basit Chaudhry MD, PhD
Founder & CEO, Tuple Health, Washington, DC

    Speaker Bio

    Basit Chaudhry MD, PhD is Founder and CEO of Tuple Health. Dr. Chaudhry is an internal medicine physician and medical technologist whose expertise focuses on healthcare payment, clinical service redesign, and the use of data analytics to improve clinical and financial performance in healthcare.

    Tuple Health works with providers, payers and purchasers to transition to new models for value based payment and collaborative, population health. Tuple Health technology enabled services including optimization of healthcare resource allocation, payment model design and implementation, utilization and financial analysis, and support for value based contracting.

    Prior to starting Tuple Health Dr. Chaudhry was a medical scientist at IBM Research where his work focused on using data analytics and information technology to drive innovation in healthcare. His work focused on improving healthcare productivity, ACO & PCMH implementation, optimizing workforce utilization, and improving the quality and efficiency of care. In addition to technology development, Dr. Chaudhry worked on developing IBM's private and public sector business strategies for the healthcare industry. Dr. Chaudhry was lead research clinician for IBM's artificial intelligence computing system Watson-famous for its victories on the quiz show Jeopardy! In this role, Dr. Chaudhry focused on developing the Watson technology for clinical practice.

    After finishing his medical training in internal medicine, Dr. Chaudhry completed the Robert Wood Johnson Clinical Scholars program at UCLA, earning a PhD focused on biomedical informatics and health services research. Dr. Chaudhry has worked in the Internal Medicine department at UCLA and as a research scientist at the RAND Corporation. He has provided expertise to the US Department of Health and Human Services and the Institute of Medicine and served on a working group of the President's Council of Advisors on Science and Technology, coauthoring its policy report, "Realizing the Full Potential of Health Information Technology."
    Presentation Material (Acrobat)


Predictive Modeling and Disease Management Applications

Steven Flores
Innovation Architect, National Government Services, Albany, NY

    Speaker Bio

    Steven Flores has a broad spectrum of experience in Medicare, Medicaid, and public healthcare policy and program analysis and project management spanning over 15 years. He has worked with multiple organizations and agencies to design, plan, implement and monitor the success of innovative healthcare initiatives in execution of their strategic plans. Mr. Flores develops and maintains policy-oriented statistical and predictive models for estimating the costs and effectiveness of Medicare and Medicare policy changes and initiatives. He serves as a Subject Matter Expert in a variety of healthcare issues and is a Lead Analyst for Medicare and Medicaid fraud control and prevention.
    Presentation Material (Acrobat)


Using Structured Post-acute Assessment Data as the Raw Material for Predictive Modeling

Thomas Martin
Research Analyst, PointRight, Cambridge, MA

    Speaker Bio

    Thomas is a Research Analyst wit PointRight in Cambridge, MA. He has a background in research and statistical methods, working extensively with resident level data in the LTC industry. He's worked on design and development of innovative metrics and products. Tom's familiar with CMS regulations, payment methodologies for Medicare, Medicaid and Medicare Advantage, as well as industry standards used to measure quality of care.
    Presentation Material (Acrobat)
12:00 pm Pre-Conference Adjournment and Networking Luncheon for Preconference Attendees


Agenda: Day I
Thursday, November 13, 2014

OPENING PLENARY SESSION
1:00 pm

Opening Plenary Session -- Welcome and Introductions

Ian Duncan, FSA, FIA, FCIA, MAAA
Adjunct Professor of Actuarial Statistics, Department of Statistics and Applied Probability, University of California, Santa Barbara, Santa Barbara, CA (Co-chair)

    Speaker Bio

    Mr. Duncan is Adjunct Professor of Actuarial Statistics, Department of Statistics and Applied Probability, University of California, Santa Barbara, Santa Barbara, CA. Ian recently served as Vice President, Outcomes and Analytics for the Walgreen Cos. in Deerfield, IL. where he was responsible for all the company's clinical research and publications. He was formerly president and founder of Solucia Consulting, a SCIOinspire company, a provider of analytical and consulting services to the healthcare financing industry.

    Mr. Duncan holds a post-graduate degree in economics from Balliol College, Oxford, and is a fellow of the Society of Actuaries, the Institute of Actuaries (London) and the Canadian Institute of Actuaries. He is active in public policy and healthcare reform, and serves on the boards of directors of the Commonwealth of Massachusetts Healthcare Connector Authority and SynCare, LLC. Academically, he is a Senior Scholar of the Dept. of Health Policy of the Thomas Jefferson Medical College, an Adjunct Research Professor of the School of Healthcare Administration at Georgetown University, and Visiting Professor of Actuarial Mathematics in the Dept. of Probability and Applied Statistics at the University of California, Santa Barbara. He is the author of a number of peer-reviewed papers, (two of which have won best-paper awards from the Disease Management Association of America) and a number of books. His books include "Managing and Evaluating Healthcare Intervention Programs" (Actex Publishers, 2008) and "Healthcare Predictive Modeling and Risk Adjustment" (April 2011).
1:15 pm

Session I: Prediction vs. Intervention

Henry Wei, MD
Senior Medical Director, Aetna Innovation Labs, Instructor in Medicine, Weill Cornell Medical College; Inaugural Presidential Innovation Fellow, The White House and Department of Veterans Affairs, New York, NY

    Speaker Bio

    Henry Wei, MD is the Aetna Innovation Labs' Senior Medical Director for Clinical Innovation. Dr. Wei recently served with the White House as an inaugural Presidential Innovation Fellow. Henry is a faculty member in Internal Medicine at Cornell (Weill Medical College). Prior to his role at Aetna, Henry served as Sr. Medical Director for Clinical R&D at ActiveHealth Management. He has worked as a consultant in the healthcare practice of McKinsey & Company. Henry Wei completed his Internal Medicine residency at New York Presbyterian Hospital, along with Informatics training at Harvard Medical School and Stanford University. He holds his medical degree from Cornell, and Master's and undergraduate degrees from Harvard. Dr. Wei has won the Health 2.0 Developers World Cup, as well as the NYC-Columbia Health Code-a-thon, and is on the medical advisory board of Doximity, a physicians' social network. Henry lives in New York City with his family.
    Presentation Material (Acrobat)
2:00 pm

Session II: Population Health Management: Innovations in Risk Adjustment and Predictive Modeling

Jonathan P. Weiner, DrPH
Professor and Director of the Center for Population Health IT, Co-Developer of the Johns Hopkins ACG System, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

    Speaker Bio

    Jonathan P. Weiner, DrPH, is a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore. He is also a professor of health sciences informatics at the Johns Hopkins School of Medicine. He is the founding director of the newly formed Johns Hopkins Center for Population Health IT (CPHIT). (www.jhsph.edu/cphit) He is also the director of the Public Health Informatics certificate training program at Hopkins.

    Dr. Weiner is an internationally regarded researcher, consultant and lecturer. He is an expert in health care policy, integrated delivery systems, quality of care measurement and the application of digital data sources to research, analysis and care improvement. His current work focuses on the application of electronic health records and other e-Health tools for population based applications. He is the co-developer and team leader of the Johns Hopkins ACG case-mix / predictive modeling system, a software tool used by hundreds of private and public organization to manage the care of 100+ million patients across the US and in more than 16 nations. (www.acg.jhsph.edu)
    Presentation Material (Acrobat)
2:45 pm

Session III: High Opportunity Segmentation: Identifying, Attracting and Retaining Your Best Members

Chelsea Benning
Director of Design and Analysis, Pacific Market Research, Renton, WA

    Speaker Bio

    Chelsea Benning is Director of Research Design & Analysis. She has over 20 years of research experience helping organizations understand their business, their market, their customer, and their customers' experience.

    She specializes in understanding consumer motivations and behavior by combining statistical modeling, marketing science and social research techniques. Chelsea uses a wide variety of techniques to study consumer behavior, with the primary goal of assisting organizations in their understanding of their marketplace, their customer base and how it is shaped and defined, identification of their most valued customer, and what motivates those customers' behaviors and decisions.

    Chelsea has served as principle investigator for over 500 research programs in a wide variety of industries, including health care and health insurance, financial services and banking, lotteries and gaming, consumer packaged goods and hospitality. Healthcare clients have included Express Scripts, Premera, Harborview Medical Center, Group Health Cooperative and Carol Milgard Breast Center.

    Chelsea holds a BASW (with an emphasis on Quantitative Reasoning) from the University of Washington. She is certified in Predictive Modeling and Advanced Statistical Analysis Techniques and Methodology and has completed the Principals of Marketing Research from the University of Georgia.
Briana Marrah
Strategy Director, GreenRubino, Seattle, WA

    Speaker Bio

    Briana Marrah is Brand Director for GreenRubino. Briana has more than 14 years' experience in brand and marketing strategy with healthcare companies. Her approach looks at the world from the customer's point of view to create messages as well as experiences that are relevant, different and compelling. She's helped clients move beyond simple feature/function messages and commodity mentality to adopt strategies that promote strong, sustainable brands. And she does this all within a deep understanding of the complexities of the healthcare market.

    As a Principal and Co-Owner of Brand Strategy firm Parker LePla, Briana pioneered an approach to branding that aligns business strategy, internal culture, customer experiences and marketing, focused primarily on healthcare clients. She and her company joined GreenRubino in 2013 to provide clients with a fully integrated offering that spans from brand strategy all the way through to advertising, digital and PR.

    Together with Milliman and Pacific Market Research, Briana has developed a process for identifying and attracting a health plan's best prospective members, called Risk-Based Marketing. This unique combination of actuarial modeling, segmentation and marketing helps health plans determine where and how to focus their Healthcare Exchange product development and marketing efforts for the highest profitability.

    Her breadth and depth of experience with providers, payers, research and advocacy organizations, service companies and healthcare IT companies gives clients a 360 degree view of the industry. Briana's healthcare clients have included Mayo Clinic, GE Healthcare, Philips Healthcare, several of the Blues, Microsoft Health Solutions Group and Microsoft in Health, Group Health, The Fred Hutchinson Cancer Research Center, Health New England, Milliman, Wolters Kluwer Health and many others. A sought-after speaker on healthcare as well as branding and marketing, she speaks regularly at the local and national level.
Ksenia Whittal
Consulting Actuary, Milliman, Inc., Denver, CO

    Speaker Bio

    Ksenia is a consulting actuary with the Denver Health practice of Milliman. She joined the firm in 2005. Ksenia's primary focus is on predictive modeling and lifestyle based analytics application to underwriting and disease management. This work includes consulting to healthcare plans on the use of lifestyle based data to augment underwriting decisions and identify individuals for disease management and wellness initiatives. Lifestyle-based analytics plays an especially strong role in risk selection in small/medium group market, and will integrate well with other risk selection approaches such as risk adjusters, Intelliscript and medical underwriting.

    Most recently, Ksenia has been managing the technical development of the Milliman Advanced Risk Adjuster (MARA), which was released in 2010. MARA utilizes Milliman's existing actuarial and clinical expertise and is perfectly suited for advanced applications of risk adjustment in health care budgeting, pricing, payment, stratifying risks and analytic reporting. Ksenia's work in long-term care includes pricing, product development, valuations of blocks of business, filing, and large group offerings. Other recent projects include benchmarking and rate development for health plans. Ksenia is a Fellow, Society of Actuaries and Member, American Academy of Actuaries. She holds a B.M. (with distinction), Honors in Actuarial Science, from the University of Waterloo, Ontario, Canada.
    Presentation Material (Acrobat)
3:30 pm Coffee Break in the Exhibit Hall
4:00 pm

Session IV: Mental Health Fraud and Abuse: Predicting Behavioral Patterns of Mental Health Providers and Coding Practices

Steven Flores
Innovation Architect, National Government Services, Albany, NY

    Speaker Bio

    Steven Flores has a broad spectrum of experience in Medicare, Medicaid, and public healthcare policy and program analysis and project management spanning over 15 years. He has worked with multiple organizations and agencies to design, plan, implement and monitor the success of innovative healthcare initiatives in execution of their strategic plans. Mr. Flores develops and maintains policy-oriented statistical and predictive models for estimating the costs and effectiveness of Medicare and Medicare policy changes and initiatives. He serves as a Subject Matter Expert in a variety of healthcare issues and is a Lead Analyst for Medicare and Medicaid fraud control and prevention.
    Presentation Material (Acrobat)
4:45 pm

Session V: Profiling Future Mental Health and Substance Abuse Risk by Disease Specific Models

Ogi Asparouhov, PhD
Chief Scientist, LexisNexis Risk Solutions, Healthcare, Orlando, FL

    Speaker Bio

    Dr. Ogi Asparouhov, Chief Scientist, LexisNexis Company | Risk Solutions | Healthcare (MEDai), with more than 25 year experience inventing and developing solutions to address variety of pressing industry issues across clinical analytics, big data, risk adjustments and healthcare predictive modeling.

    Education: Ph.D. in Decision Making in Medicine/Healthcare, M.S. in Applied Math and Cybernetics.

    His Population Health Management & Disease Management applications and models (used by many health insurance companies and hospitals) provide the means to manage the right people at the right time with the right interventions using the right tools and achieving the following desired goals: Maximization of the Return on Investment and Best Clinical Outcomes.

    Publications: 44 articles in peer-reviewed journals; 60+ invited talks and conference presentations.
    Prior to MEDai he served as Research Professor and Director of Research Institute of the Bulgarian Academy of Sciences.
    Presentation Material (Acrobat)
5:30 pm

Session VI: Vulnerable Patients and the Patient Experience

Dennis O. Kaldenberg
Chief Scientist and Senior Vice President, Press Ganey Associates, South Bend, IN

    Speaker Bio

    As Chief Scientist at Press Ganey, Dennis Kaldenberg provides leadership to the areas of research and analytics including such issues as data integration, information collection protocols and the accurate and useful dissemination of information. During his tenure he has been instrumental in the creation and revision of many tools to measure patient experience, patient satisfaction, and other patient reported outcomes. Dr. Kaldenberg has written on a variety of topics related to patient satisfaction, health care service delivery, health care professionals, and research methods. He has publications in over 25 peer-reviewed journals and books. He has presented at the national meetings of numerous health care professional associations, Dr. Kaldenberg received his Ph.D. from Iowa State University with a specialization in research methods.
    Presentation Material (Acrobat)
6:15 pm Adjournment and Networking Reception in the Exhibit Hall

Go to Agenda:
Day II / Postconference




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